Treatment Outcomes in Children with Very High Risk Acute Lymphoblastic Leukemia Intended to Treat with Allogeneic Hematopoietic Stem Cell Transplantation

The prognosis of very high risk group acute lymphoblastic leukemia (VHR ALL) in childhood is generally poor in spite of intensive chemotherapy. Recently, allogeneic hematopoietic stem cell transplantation (Allo-HSCT) was use to treat the patients with VHR ALL. We studied the clinical course and outcomes of children with VHR ALL intended treat with Allo-HSCT after chemotherapy. 16 children who were diagnosed as VHR ALL and were intended to treat Allo-HSCT at the department of Pediatrics in Ajou University Hospital between June 2001 and June 2010. We analyzed their cumulative survival rate and clinical characteristics among them. Among 148 ALL patients, 16(10.8%) were classified as VHR ALL. Eight of them had Philadelphia chromosome, four were infant ALL with mixed lineage leukemia (MLL) gene rearrangement, seven had hyperleukocytosis. Fourteen received Allo-HSCT and the other two could not received Allo-HSCT. Bone marrow or central nervous system (CNS) relapse was the main cause of mortality in the patients who received Allo-HSCT. Event free survival (EFS) and overall survival (OS) in all patients were 64.7% and 57.7%, respectively. EFS in the patients Philadelphia chromosome, infant ALL with MLL gene rearrangement and hyperleukocytosis were 58.3%, 100% and 37.5% respectively. EFS in patients with hyperleukocytosis at the time of diagnosis is as low. Therefore novel or additional ggressive treatment modalities may be required in hyperleukocytosis patients. However infant ALL with MLL gene rearrangement was used bulsulfan/cyclophosphamide as a conditioning regimens may have promising survival outcomes.

Author dc:creator

• 이, 민주

Contributors dc:contributor

• 박, 준은
• 대학원 의학과
• 200924244

• Acute lymphoblastic leukemia
• Allogeneic hematopoietic stem cell transplantation
• Very high risk group

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000012680
000000012680

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/7635